Acute and Chronic Otitis Externa Referral Access Criteria

Referrers should use this page when referring patients to public adult ENT outpatient services for acute and chronic otitis externa.

Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
Otalgia disproportionate with signs in diabetic patient unresponsive to topical therapy (refer immediately to ED to exclude skull base osteomyelitis / malignant otitis externa) Ear canal occluded by oedema and unable to clear discharge

Immediate referral
Immediately contact on-call registrar or service to arrange immediate ENT assessment (seen within 7 days):
Nil To contact the relevant service, see Clinician Assist WA: Acute ENT assessment (external site)

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
Patients must present with chronic otitis externa, of duration greater or equal to one month, causing significant morbidity and not responding to recommended treatment Acute otitis externa will only be seen if not responding to standard treatments or if complications present (granulation tissue in ear canal, facial weakness, severe nighttime pain, immunosuppressed patients, diabetic patients, pinna cellulitis)

Clinical indications for outpatient referral

If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).

Patients must present with chronic otitis externa, of duration greater or equal to one month, causing significant morbidity and not responding to recommended treatment
Acute otitis externa will only be seen if not responding to standard treatments or if complications present (granulation tissue in ear canal, facial weakness, severe nighttime pain, immunosuppressed patients, diabetic patients, pinna cellulitis)

Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason). This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History	Relevant history, onset, duration of symptoms including: otalgia, hearing loss, otorrhoea, pruritic ear canal, facial cellulitis history of ear canal trauma (e.g. cotton bud/hair pin) Details of previous treatment and outcome Relevant medical history (include diabetic history) Degree of functional impairment e.g. quality of life
Examination	Nil
Investigations	M/C/S ear swab

Indicative clinical urgency category
Category 1 Appointment within 30 days	Suspected skull base osteomyelitis / malignant otitis externa – severe pain, not responding to topical treatments in an immunosuppressed or diabetic
Category 2 Appointment within 90 days	No defined category 2 criteria
Category 3 Appointment within 365 days	Chronic otitis externa not responding to treatment

Indicative clinical urgency category

Category 1

Appointment within 30 days

Suspected skull base osteomyelitis / malignant otitis externa – severe pain, not responding to topical treatments in an immunosuppressed or diabetic

Category 2

Appointment within 90 days

Category 3

Appointment within 365 days

Exclusions
Nil

Useful information
Nil

If you would like to submit feedback on the contents of the Referral Access Criteria, please complete this form.

Last reviewed: 16-08-2024

Related links